Magazine article American Nurse Today

Hook-and-Loop Alarm Belt: A Vital Component in a Fall-Prevention Toolkit

Magazine article American Nurse Today

Hook-and-Loop Alarm Belt: A Vital Component in a Fall-Prevention Toolkit

Article excerpt

In 2012, Yale New Haven Hospital's fall-prevention charter noted a hospital-wide increase in patient falls from chairs. Simultaneously, its restraint committee was working to reduce the use of physical restraints, in part because the state's rehabilitation facilities require patients to be restraint-free for 24 hours before discharge.

The fall-prevention charter and restraint committee collaborated to test a fall-prevention product called the hook-and-loop alarm belt * for possible addition to the hospital's multilayered fall-prevention initiatives. The value of the belt is that it doesn't restrain patients. Instead, the hook-and-loop strap lets patients remove the belt themselves, serving as a reminder rather than a physical restraint. Also, the alarm quickly alerts nursing staff that the patient's attempting to stand.

Indications for the hook-and-loop alarm belt include poor trunk control, impaired standing balance (which could cause the patient to fall immediately when unattended), impulsiveness, impaired cognition with reduced insight into limitations, frequent attempts to get up despite instructions not to do so, ineffectiveness of a regular chair alarm, and high fall-risk status.

For a patient with an abdominal wound, abdominal tubes, or any tube, device, incision, or wound in or around the waist area, the nurse should determine if the belt is the most appropriate product. It shouldn't be used for patients who are at risk for suicide, are restless when sitting, can't demonstrate how to open the belt, or tend to slide up and down.

Pilot program and hospital-wide rollout

The hook-and-loop alarm belts were piloted on the neuroscience service for 2 months. Results of staff surveys indicated the belt was effective and easy to use. The belts were rolled out hospital-wide in 2012 with the manufacturer providing staff education. All patient-care personnel were tested to determine if they knew how to use the belt alarm properly.

In 2014, the NICU used the belt consistently, along with alarm bed pads *. Although most patients were cognitively impaired, the NICU had no falls for an entire year--especially impressive as the unit was in the process of implementing an initiative to get patients up in chairs and moving as soon as possible. …

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